不同浓度的瑞芬太尼用于分娩镇痛的研究

目的:探讨瑞芬太尼用于无痛分娩的镇痛效果对产妇产程进展的影响。方法:150例阴道分娩健康初产妇的临床资料根据静脉输注瑞芬太尼浓度的不同分为A、B、C 3组,每组50例,瑞芬太尼背景输注浓度分别为0.02μg/kg/min、0.04μg/kg/min、0.06μg/kg/min。比较3组产妇产程时间及宫缩疼痛视觉模拟评分(VAS)、Ramsay镇静评分、应用催产素情况、剖宫产率及新生儿Apgar评分。结果:3组产妇第一产程活跃期分别为(255±112)min、(274±136)min及(214±106)min,第二产程时间分别为(54±39)min、(59±41)min及(66±45)min,第三产程时间分别为(15±9)min、(9±9)min、(12±10)min。VAS评分C组最高,A组最低,Ramsay评分C组最高且2例出现过度镇静,3例胎心监测出现心率减慢,停用瑞芬太尼后好转。3组产妇在宫缩、应用催产素及器械助产的情况、剖宫产率及新生儿Apgar评分无显著性差异(P>0.05)。结论:瑞芬太尼实施分娩镇痛,对产妇产程无明显影响,瑞芬太尼背景输注速度不宜超过0.04μg/kg/min。

The effect of remifentanil by patient-controlled intravenous analgesia in labor

Objective:To observe the effect of remifentanil on labor by the way of patient-controlled intravenous analgesia.Methods:150 parturients were divided into three groups,different rates of remifentanil were infused respectively at 0.02,0.04,0.06 μg·kg-1·min-1,the duration of birth process,VAS scale,Ramsay scale,incidence of using hypophamine,uterine-incision and Apgar grade were recorded.Results:The duration of the three stages of labor in three groups were respectively(255±112),(274 ±136),(214±106);(54±39),(59±41),(66±45);(15±9),(9±9),(12±10) min.The Ramsay scale was higher in group C than that of the other two groups.There were no differences of incidence in using hypophamine and uterine-incision.Conclusion:Application of patient-controlled intravenous analgesia with remifentanil on labor is a safe and effective way during deliver,but the infusing rate should be controlled below 0.04 μg·kg-1·min-1.